Integrated MR imaging and interventional coil device method and system

ABSTRACT

MR imaging and intervention functions are localized within a single device. At least one integrated coil device which has at least one RF coil, a housing which encases the RF coil and provides an anatomically conformal surface, and a plurality of apertures. The integrated coil device slides along a guide rail system to adjust the size of a patient anatomical imaging region. The apertures in the integrated coil device are available to secure tool holder grid plate inserts or other interventional device guides. The inserts assist in holding the soft tissue for diagnostic imaging and provide support for biopsy/interventional instrument guides. The integrated MR imaging and interventional coil device works in combination with a prone patient support structure, an adaptive torso sling, and also features an open architecture design for improved patient access. The device also works for supine or side imaging procedures.

CROSS-REFERENCE TO PRIOR APPLICATIONS

This application claims the benefit or priority of and describesrelationships between the following applications: wherein thisapplication is a continuation of U.S. patent application Ser. No.14/342,456 filed Mar. 3, 2014, which is the National Stage ofInternational Application No. PCT/IB2012/054432 filed Aug. 29, 2012which claims priority to U.S. Provisional Application 61/536,175 filedSep. 19, 2011, all of which are incorporated herein in whole byreference.

The present application relates to the magnetic resonance arts. It findsparticular application in conjunction with devices and methods for thescreening, diagnosis, and intervention of breast cancer.

Breast cancer is a fatal disease caused by the growth of cancerous cellswithin breast tissue. There cancerous cells form a lump, cyst, lesion,or the like that can grow at an alarming rate and, if left undetected,can even spread beyond the breast. Mammography and physical examinationis currently the method of choice for screening and diagnosing breastcancer or other breast malignancy. In mammography, low-dose X-rays areused to generate a radiograph of the breasts. However, other breastimaging exams are often used to supplement the mammogram when furtherevaluation is necessary. For example, an ultrasound is typically usedfor further evaluation of masses found on the mammogram or palpablemasses not seen on the mammogram. Though more costly than x-raymammography, magnetic resonance imaging (MRI) is more sensitive and candetect lesions at an earlier stage than tradition x-ray mammography.Furthermore, MRI does not suffer from the high false negative rate ofx-ray mammography. This is partly due to dense tissues obscuring thecancer or malignancy and the fact that the appearance of cancer on x-raymammograms has a large overlap with the appearance of normal tissues.

In an MRI or MR spectroscopy (MRS) examination, the patient is subjectedto a uniform magnetic field which aligns nuclear spins of the bodytissue along an axis, typically the z-axis in a Cartesian coordinatesystem. The aligned nuclear spins are then excited by transversemagnetic fields B₁ oscillating in the radiofrequency band. In imaging,relaxation signals are exposed to gradient magnetic fields to localizethe resultant resonance. The relaxation signals are received in order toform in a known manner a single or multi-dimensional image. Inspectroscopy, information about the composition of the tissue is carriedwith the frequency component of the resonance signals.

An RF coil system provides the transmission of RF signals and thereception of resonance signals. In addition to the RF coil system whichis permanently built into the imaging apparatus, special purpose coilscan be flexibly arranged around or in a specific region to be examined.Special purpose coils are designed to optimize signal-to-noise ratio(SNR), particularly in situations where homogeneous excitation and highsensitivity detection is required. For example, for breast cancerscreening a local breast coil is typically employed. A female patient isarranged in the prone position and the breast is positioned in the localbreast coil beneath a specialized patient support on which the patientis laying.

MRI has relatively high sensitivity compared to x-ray mammography andultrasound, but suffers from low sensitivity in determining whether adetected tumor is benign or malignant. The poor specificity coupled withlow throughput of MRI breast screening limits MR based screening to highrisk patients rather than general screening.

Due to the low specificity of these devices, they are adept for imagingthe breast, however if the clinician locates a malignancy and determinesa biopsy is necessary, the patient is relocated to patient supportdesigned for biopsy. The procedure of repositioning the patient iscumbersome and time consuming for the patient, and it also introducesspatial position error into the biopsy procedure. When the patient ismoved, he/she must be registered with the biopsy device to ensure thetissue from the malignancy is sampled rather than erroneously samplingthe surrounding tissue.

The present application provides a new and improved method and systemwhich overcomes the above-referenced problems and others.

In accordance with one aspect, an integrated MR imaging andinterventional coil system is presented. The integrated system includesa support structure configured to be mounted in an MR imaging space andat least one lateral or medial coil device which define and adjust ananatomical receiving region between them. Each coil device includes atleast one radiofrequency (RF) coil element and a housing havingconformal surface to a patient anatomical portion received in theanatomical receiving region. The housing also includes apertures whichdefine the trajectory for an interventional device into the anatomicalportion.

In accordance with another aspect, a method immobilizing a patientduring combined MR imaging and intervention is presented. The methodincludes positioning a patient with a selected anatomical region in ananatomical receiving region of a support structure. The method furtherincludes immobilizing the patient anatomical portion between a lateralcoil device and a medial coil device by independently translating thecoil devices to adapt the anatomical receiving region to the receivedanatomical portion. This method can be used to immobilize a patientbreast and/or axilla region and improve comfort for the patient when inthe prone or supine position over the support structure.

One advantage resides in improved patient comfort.

Another advantage resides in improved patient safety.

Another advantage resides in that workflow for imaging and interventionis improved.

Still further advantages of the present invention will be appreciated tothose of ordinary skill in the art upon reading and understanding thefollowing detailed description.

The invention may take form in various components and arrangements ofcomponents, and in various steps and arrangements of steps. The drawingsare only for purposes of illustrating the preferred embodiments and arenot to be construed as limiting the invention.

FIG. 1 is a diagrammatic illustration of an integrated MR imaging andinterventional system with a localized diagnostic coil andinterventional patient support;

FIG. 2 is an assembled and exploded diagrammatic illustration of thelocalized diagnostic coil and interventional patient support;

FIG. 3 is an exploded diagrammatic illustration of a medial integratedMR diagnostic imaging coil device as part of the localized diagnosticcoil and interventional patient support;

FIG. 4 is an assembled and exploded diagrammatic illustration of analternative embodiment of a medial integrated MR diagnostic imaging coildevice as part of the localized diagnostic coil and interventionalpatient support;

FIG. 5 is an exploded diagrammatic illustration of a lateral integratedMR diagnostic imaging and interventional coil device as part of thelocalized diagnostic coil and interventional patient support;

FIGS. 6 and 7 are assembled perspective views of the lateral integratedMR diagnostic imaging and interventional coil device with a targetingblock and interventional device;

FIG. 8 is a diagrammatic illustration of another embodiment of thelocalized diagnostic coil and interventional patient support including aone piece patient comfort pad and a non-ferromagnetic lighting system;

FIG. 9 is a diagrammatic illustration of another embodiment of thelocalized diagnostic coil and interventional patient support includingadjustable clavicle support pads;

FIG. 10 is a side view diagrammatic illustration in partial section ofanother embodiment of the localized diagnostic coil and interventionalpatient support with a torso support sling and breast blocker;

FIG. 11 is a side view diagrammatic illustration in partial section ofanother embodiment of the localized diagnostic coil and interventionalpatient support with the torso support sling, breast blocker, and a onepiece patient support pad; and

FIG. 12 is a flow chart of a method for magnetic resonance imaging andintervention with the localized diagnostic coil and interventionalpatient support.

With reference to FIG. 1, an integrated magnetic resonance (MR) imagingand interventional system 10 includes a main magnet 12 which generates atemporally uniform B₀ field through an examination region 14. The mainmagnet can be an annular or bore-type magnet, a C-shaped open magnet,other designs of open magnets, or the like. Gradient magnetic fieldcoils 16 disposed adjacent the main magnet serve to generate magneticfield gradients along selected axes relative to the B₀ magnetic fieldfor spatially encoding magnetic resonance signals, for producingmagnetization-spoiling field gradients, or the like. The magnetic fieldgradient coil 16 may include coil segments configured to producemagnetic field gradients in three orthogonal directions, typicallylongitudinal or z, transverse or x, and vertical or y directions.

A radio-frequency (RF) coil assembly 18, such as a whole-body radiofrequency coil, is disposed adjacent the examination region. The RF coilassembly generates radio frequency pulses for exciting magneticresonance in aligned dipoles of the subject. The radio frequency coilassembly 18 can also serve to detect magnetic resonance signalsemanating from the imaging region. The whole body coil can comprise of asingle coil or a plurality of coil elements of an array as in a paralleltransmit system. In parallel transmit systems, the k-space trajectorycan be configured for a specific spatial sensitivity which ultimatelyshortens the overall pulse length. In one embodiment, the k-spacetrajectory determined by the gradient system, i.e. the gradient coil 16and gradient controller 24, is the same for all transmit coils. Inanother embodiment, different B₁ pulses are determined individually foreach transmit element of the transmit coil array.

In addition to the whole-body RF coil 18, a localized diagnostic coiland interventional patient support 20 is disposed in the examinationregion to provide more sensitive, localized spatial encoding,excitation, and reception of magnetic resonance signals from ananatomical, receiving or imaging region 60 while providing dedicatedinterventional capabilities. The patient support 20 provides comfort tothe patient during immobilization of an anatomical region. For example,during an MR imaging and biopsy procedure, the breast or chest is imagedwhile the patient is typically in prone position with the breastimmobilized in a specialized patient support 20 with imagingcapabilities which is placed on an examination table which translates inand out of the MR scanner examination region 14. If a tissue mass ormalignancy is detected, the patient and the imaging patient support 20are removed from the examination region 14 and a biopsy patient support20 is then used to collect a tissue sample of detected tissue mass.During the biopsy procedure, the patient, the biopsy support, and biopsyneedle are routinely imaged, often using x-ray fluoroscopy, whichensures an optimal trajectory of the biopsy needle to the tissue mass isachieved. This procedure may include several of iterations where thepatient and biopsy needle are imaged together using the x-rayfluoroscopy system or in the MRI system using the whole-body RF coil 18until the needle tip is positioned within the tissue mass to acquire asample. The patient support 20 improves patient comfort and workflow byproviding both imaging capabilities and interventional capabilitieswithout having to reposition the patient between a dedicated imagingsupport and a dedicated interventional support. The patient support 20also works for supine or side imaging procedures.

To acquire magnetic resonance data of a subject, the subject is placedinside the examination region 14, preferably at or near an isocenter ofthe main magnetic field. A scan controller 22 controls a gradientcontroller 24 which causes the gradient coils 16 to apply the selectedmagnetic field gradient pulses across the imaging region, as may beappropriate to a selected magnetic resonance imaging or spectroscopysequence. The scan controller 22 also controls at least one RFtransmitter 26 which causes the whole-body RF coil 18 and/or the patientsupport 20 to generate magnetic resonance excitation and manipulation ofB₁ pulses. In a parallel system, the RF transmitter 24 includes aplurality of transmitters or a single transmitter with a plurality oftransmit channels, each transmit channel operatively connected to acorresponding coil element of the array.

The scan controller 22 also controls an RF receiver 28 which isconnected to the RF coil 18 and/or the patient support 20 to receive thegenerated magnetic resonance signals therefrom. The received data fromthe receiver 28 is temporarily stored in a data buffer 30 and processedby a magnetic resonance data processor 32. The magnetic resonance dataprocessor can perform various functions as are known in the art,including image reconstruction (MRI), magnetic resonance spectroscopy(MRS), catheter or interventional instrument localization, and the like.Reconstructed magnetic resonance images, spectroscopy readouts,interventional instrument location information, and other processed MRdata are stored in memory, such as a medical facility's patient archive.A graphic user interface or display device 34 includes a user inputdevice which a clinician can use for controlling the scan controller 22to select scanning sequences and protocols, display MR data, and thelike.

The MR system 10 includes a planning processor 36 which determines theposition of a tissue mass of interest relative to the patient support 20and the examination region 14. With the position of the tissue mass andthe patient support 20 known, the planning processor 36 determines anoptimal trajectory for an interventional device, such as a biopsyneedle, to reach the detected tissue mass.

With reference to FIG. 2, the patient support 20 is illustrated in anexploded view. An assembled patient support 21 is illustrated with allparts in place. When disassembled, the patient support 20 includes acoil base 40 which provides mounting structures and tracks for adjustingthe position of various elements of the patient support 20. The support20 includes various adjustable support structures to improve thepatient's comfort during and imaging and/or interventional procedure.For example, the support 20 includes an adjustable headrest 42 whichaccommodates various neck lengths and head sizes. The headrest can beadjusted with a knob, or the like. The support 20 also includesadjustable clavicle supports 50 which support the patient's clavicle andupper chest at various x-positions, or heights. To accommodate varioustorso sizes, the support includes an adjustable torso support 52. Asillustrated in FIG. 2, a one piece patient comfort pad 53 is attached tothe clavicle supports 50 and the torso support 52 which conforms to thebody and provides cushioned support to the shoulders, torso, and hips.In one embodiment, the torso support 52 includes an air bladder whichinflates and deflates to accommodate the various torso sizes. However,other embodiments are also contemplated such as various sized torsosupports which are interchangeably mounted on the patient support 20. Tosupport the lower torso, waist, and upper legs, an adjustable accessorypad 54 ramps down from the torso support. Similar to the torso support52, the accessory pad may include an air bladder to adjust the size toaccommodate various patient sizes and geometry. However, employingmultiple accessory pads of various sizes and shapes is alsocontemplated. The support structures, headrest 42, clavicle supports 50,the torso support 52, and accessory pad 54, are constructed from amulti-density foam to conform to the patient's anatomy and to reducestress on pressure points.

The patient support also includes detachable hand rails 56 which assistthe patient when getting into and out of the prone position on top ofthe patient support. The hand rails are detached during an imagingprocedure to reduce image artifacts or during an interventionalprocedure to present a clinician unobstructed access to the patient'schest or breast.

Once the patient is comfortably situated in the support 20, thepatient's anatomical region, under examination, is surrounded by a leftlateral integrated MR diagnostic imaging and interventional coil device62, a medial integrated MR diagnostic imaging coil device 63, and aright lateral integrated MR diagnostic imaging and interventional coildevice 64. The coil devices 62, 63, 64 independently translate in they-direction along tracks 66 in the coil base 40 to immobilize theanatomical region during imaging and interventional procedures. Thelateral imaging and intervention coil devices 62, 64 move along anangled portion on the edges of the tracks 66, while the medial coildevice 63 remains stationary on or moves along a central straightportion in the center of the tracks 66. The coil devices 62, 63, 64 arecontoured to improve patient comfort. Though illustrated as a pair oflateral coil devices 62, 64, a single lateral coil can be used inconjunction with the medial coil device 63 to immobilize a singlebreast. An adaptable torso support sling 55 is attached to the claviclesupports 50 and the torso supports 52 to provide a flexible torsosupport that is adaptable to individual patients.

With reference to FIG. 3, the medial integrated MR diagnostic imagingcoil device 63 is illustrated in greater detail. In the illustratedembodiment, the medial coil device 63 includes an inner/bottom housing70 which is attached to a center RF coil 72 surrounded by an outer/tophousing 74. The center coil 72 provides localized spatial encoding,excitation, and reception of magnetic resonance signals and ispermanently sealed within the housing pieces, which arenon-ferromagnetic. The center coil 72 includes one or more coil loops toform various combinations of single loop coils, multi-loop coils,saddle-loop coils, and saddle-saddle coil. The outer/top housing 72includes channels 76, and the inner bottom housing 70 includes channels78 that slide along and interlock with the tracks 66 of the coil base 40to translate and position the medial coil device 63 in the y-direction.Each channel is associated with a locking mechanism 80, such as a leverwhich exerts a frictional force on the corresponding track 66, to fixthe y-position of the medial coil device 63. When examining theanatomical region, the medial coil device 63 is used in conjunction withthe lateral integrated MR diagnostic imaging and interventional coildevice 62, 64 to surround the region, e.g. breast, on both sides. Themedial coil device 63 contains two opposite facing conformal surfaces toachieve a contoured fit with the human body during examination of theanatomical region.

With reference to FIG. 4, another embodiment of a medial integrated MRdiagnostic and interventional coil device 90 is illustrated. Anassembled medial coil device 90 is illustrated with all parts in place.When disassembled, the medial coil device 90 includes a medial gridplate tool holder insert 67 which is attached to an inner housing 92, acenter coil 94, and an outer housing 96. The center coil 94 provideslocalized spatial encoding, excitation, and reception of magneticresonance signals and is permanently sealed within the inner and outerhousing pieces 92, 96, which are non-ferromagnetic. The center coil 94includes one or more coil loops to form various combinations of singleloop coils, multi-loop coils, saddle-loop coils, and saddle-saddle coil.The outer housing includes the channels 98 which receive the tracks 66of the coil base 40 to translate the medial coil device 90 in they-direction. Each channel is associated with a locking mechanism 100,such as a lever which exerts a frictional force on the correspondingtrack 66, to fix the medial grid plate's y-position. When examining thebreast region, the medial coil device 90 is used in conjunction with thelateral integrated MR diagnostic imaging and interventional coil devices62, 64 to surround both breast regions on both sides. The medial coildevice 90 can be used alternatively in place of medial coil device 63 toenable both imaging and interventional functions on the medial side ofthe anatomical region. The lateral coil device 64 contains two conformalsurfaces to achieve a contoured fit with the human body, particularlythe breasts, during examination of the anatomical region.

The tool holder insert 67 typically includes 40 grid locations, howevermore or less grid locations are also contemplated. The medial coildevice 90 includes one or more fiducial markers 102 to register the gridplate's location relative to the examination region 14. The positioninformation can be used to localize a detected tissue mass relative tothe frame of reference of the patient support 20 and assist with abiopsy/interventional procedure. With the position of the tissue massand tool holder insert 67 available, a clinician can position atargeting block 140 (FIG. 6) and an interventional instrument 142 (FIG.6) for an optimal trajectory. The target block is inserted into one ofthe grids of the tool holder insert 67 to define an approach path andthe instrument is inserted in the tool holder insert to perform alocalized interventional procedure.

With reference to FIG. 5, the right lateral integrated MR diagnostic andinterventional coil device 64 is illustrated. An assembled lateral coildevice 65 is illustrated with all parts in place. When disassembled, theright lateral coil device 64 includes an inner housing 110, a lowerbreast RF coil 112, and an outer housing 114 which supports a lateralgrid plate tool holder insert 116. The lower RF coil 112 provideslocalized spatial encoding, excitation, and reception of magneticresonance signals and is permanently sealed within the housing pieces110, 114, which are non-ferromagnetic. The lower RF coil 112 includesone or more coil loops to form various combinations of single loopcoils, multi-loop coils, saddle-loop coils, and saddle-saddle coil. Anupper or axilla RF coil 118 extends above the lower RF coil 112 and isangled relative to the lower RF coil 112. The tool holder grid insert116 and lower and upper coils 112, 118 are permanently sealed within thehousing pieces 110, 114. The lateral coil device 64 includes channels120 that slide along and interlock with the tracks 66 of the coil base40 to translate and position the lateral coil device 64 in they-direction. Each channel is associated with a locking mechanism 122,such as a lever which exerts a frictional force on the correspondingtrack 66, to fix the medial coil device's y-position. The lateral coildevice 64 contains a conformal breast surface in a breast portion 123and an angled conformal axilla surface on an axilla portion 125 toachieve a contoured fit with the human body during examination of thebreast region.

The tool holder grid insert 116, for example, includes 60 grid locationswhile more or less grid locations are also contemplated. The lateralcoil device 64 includes one or more fiducial markers 124 to register thecoil device's location relative to the examination region 14. Theposition information can be used to localize a detected tissue mass andassist with a biopsy/interventional procedure. With the position of thetissue mass and the position of the lateral coil device, a clinician canposition a targeting block 140 and interventional instrument 142 for anoptimal trajectory. As illustrated in greater detail in FIGS. 5, 6 and7, the left lateral coil device 62 is a mirror image of the rightlateral coil device 64. Alternatively, the left and right lateral units62, 64 are the same and are rotated 180° to switch between left andright.

The lateral and medial coil devices 62, 63, 90, 64 communicate with theRF transmitter 24 and the RF receiver 28 via integrated connectors 126which provide at least one of a digital, optical, inductive, andwireless communication to the RF receiver 28 or the RF transmitter 24while the lateral and/or medial coil devices 62, 63, 90, 64 are beingpositioned. The integrated connectors 126 also form a data interfacewhich carries at least MR signals including at least one of a slidinginterconnection, a fiber optic connection, a wireless interconnection,and an inductive interconnection that does not interfere with the RFexcitation signals or induced MR signals.

With reference to FIGS. 6 and 7, the right lateral integrated MRdiagnostic imaging and interventional coil device 64 with a targetingblock and interventional device is illustrated. The lateral coil device64 includes an axilla grid plate 130 affixed to the axilla portion ofthe lateral coil device 64. The axilla grid plate 130 is configured todefine paths generally perpendicular to the patient's axilla andprovides grid locations which facilitate selection of an optimaltrajectory to the patient's axilla. In the illustrated embodiment, thelateral coil device 64 includes, for example, 8 axilla grid locations.

The axilla grid plate 130 includes the integrated axilla RF coil 118which provides localized spatial encoding, excitation, and reception ofmagnetic resonance signals. The axilla RF coil 118 is an extension ofthe lower lateral RF coil integrated into the lateral coil device 64 asillustrated in FIG. 5. Alternatively, the axilla RF coil 118 is aseparate structure which is selectively connected to either the left orright lateral RF coil device 62, 64. Similar to the lateral and medialcoil devices, the axilla grid plate 130 encapsulates the axilla RF coil118 and corresponding electronics in a non-ferromagnetic housing whichforms the conformal axilla grid plate 130. The axilla RF coil 118includes one or more coil loops to form various combinations of singleloop coils, multi-loop coils, saddle-loop coils, and saddle-saddle coil.

An interventional device 142, such as a biopsy needle or the like, ispositioned generally perpendicular to a patient's axilla region. To makeuse of an interventional device 142 to perform an interventionalprocedure in a patient's axilla region, a targeting block 140 isinserted into one grid location of the axilla grid plate 130 whichprovides an optimal trajectory to a detected tissue mass of interest.The targeting block 140 inserted into any one of the grid locationsincludes one or more guide holes which more accurately define theselected trajectory of the interventional device 142 to a reach a targetdestination, such as a tissue mass or malignancy of interest.

Once the planning processor 36 determines the optimal trajectory basedon the detected position of the tissue mass and the fiducial markers102, 124 of the medial and/or lateral coil devices, the planningprocessor 36 determines the grid hole and type of targeting block 140 tobe inserted in the guide hole. A plurality of the targeting blocks 140are available with various angles, positions, sizes, and the like fororienting the selected interventional device 142 relative to the grid.Each type of targeting blocks 140 and each type of interventionalinstrument 142 are coded and stored in a database accessible by theplanning processor 36. Once the grid position, type of targeting block,guide hole, and interventional instrument is determined by the planningprocessor for the selected intervention, the planning processor displaysthe corresponding information on the user interface 34 for theclinician. The information can be overlaid on the reconstructed imagerepresentations of the patient's anatomical region.

The axilla grid plate 130 is removably attached to the axilla coilhousing so that different grid patterns can be selected. For example,the grid position of the axilla grid 130 illustrated in FIG. 6 isconfigured to guide the instrument along more horizontal trajectories.For more vertically oriented trajectories, the axilla grid 130 isremoved and the target block 140 is mounted in a grid section 131.

With reference to FIG. 8, another embodiment of the patient support 20including a non-ferromagnetic lighting system 150 is illustrated. In theillustrated embodiment, the coil base 40 includes the non-ferromagneticlighting system 150, such as a fiber optic lighting system, to aid theclinician during an interventional procedure by maximizing illuminationand minimizing shadowing. The lighting system 150 may also include LEDs,reflective elements, or similar lighting system. The lighting system 150is powered by the MR system 10, a battery, an RF source coupled to theMR system 10, or an inductively coupled power source. The lightingsystem 150 is alternatively or additionally located on either the medialand/or lateral coil devices 62, 63, 90, 64, the clavicle support 50, orthe torso support 52. The lighting system 150 illuminates the patientbreast or chest in or near the anatomical receiving region 60. Theintensity of the lighting system 150 is adjusted with a dimming switch,an adjustable lens, or the like which focuses the emitted light. The onepiece patient comfort pad 53 is also shown in the illustratedembodiment, which attaches to the clavicle supports 50 and torso support52 and provides cushioning support to the chest and torso.

With reference to FIG. 9, another embodiment of the patient support 20including clavicle support pads 160 is illustrated. In lieu of a onepiece patient comfort pad 53, cushions 160 are placed on the adjustableclavicle supports 50. An adjustable accessory pad 54 ramps down from thetorso support 53. The cushions 160 on the clavicle supports andaccessory pad 54 may be of varying shapes and sizes and are constructedfrom a multi-density foam to conform to the patient's anatomy and toreduce stress on pressure points. The detachable hand rails 56 have beenmodified with an extra grip 162 to assist the patient when getting intoand out of the prone position on top of the patient support.

In the embodiment of FIG. 9, two of the medial coil devices 90 areillustrated. The two medial coil devices 90 are independently movablealong the tracks 66 for greater flexibility of adjustment.

With reference to FIG. 10, in another embodiment of the patient support20, the adaptive torso support sling 55 and a breast blocker 170 isillustrated. The breast blocker 170 is a sling attached to the claviclesupports 50 and the torso supports 52 to provide a flexible support thatis adaptable to individual patients. The breast blocker 170 also ensuresthe one breast does not interfere with the imaging or interventionalprocedure on the other. The breast blocker 170 compresses the otherbreast against the patient's chest. The breast blocker 170 is a meshfabric that is movably positionable in a position to compress eitherbreast or removed from the patient support 20 entirely. The breastblocker 170 permits unobstructed medial access to the other breastduring an intervention.

With reference to FIG. 11, another embodiment the patient support 20with the one piece patient comfort pad 53 and the adaptive torso supportsling 55 is illustrated. The combination of these support elementsprovides exceptional patient support and advantages when performingimaging and/or interventional procedures on the breast region.

With reference to FIG. 12, one advantage of the patient support 20 withintegrated MR imaging coils and interventional support with lateral andmedial coil devices which accommodate various targeting blocks andinterventional devices resides in improvements in workflow. The patientcan be imaged and operated on without having to be removed orrepositioned in a patient support. With reference primarily to FIG. 12,and secondary reference to FIG. 1, an examination table is translatedout of the examination region 14 and the patient support 20 is affixedthe examination table. Once secured, a patient is positioned S100 proneon the patient support 20 with one or both of the patient's breastsdisposed in anatomical receiving regions 60 between the lateral andmedial coil devices 62, 63, 90, 64. The patient can assist his orherself into the prone position with the detachable hand rails 56. Oncein the prone position, the headrest 42, clavicle support 50, torsosupport 52, and accessory pad 54, or one piece patent support pad 53 areadjusted to the patient's geometry S102 to improve comfort. Reducingpatient discomfort my increase image quality and reduce interventionerror because the patient is less likely to move around than when she isuncomfortable.

The patient breast is immobilized S104 between the lateral and medialcoil devices 62, 63, 90, 64. The coil devices are independentlytranslated. Once immobilized, the clinician locks the position of thelateral and medial coil devices by engaging the locking mechanism 80,100, 122. In an optional step, the clinician can compress the patient'sother breast S106, the breast not being examined, using the breastsupport 170. The breast support 170 is attached to the patient support20 and extends across the unused portion of the anatomical receivingregion 60. Compressing the patient breast against the chest may reduceinductive on the imaged breast which can affect image quality. It alsoallows for unobstructed access to the medial coil device 90 by theclinician during an interventional procedure.

With the patient situated and the breast immobilized, the cliniciancontrols the MR scanner 10 to acquire an image representation S108 ofthe patient breast(s). The scanner controller 22 controls the RFtransmitter 26 to transmit an RF excitation pulse to the whole body RFcoil 18 and/or the RF coils 72, 94, 112, 118 integrated into coildevices 62, 63, 90, 64 and axilla grid plate 130 to induce an MR signalin the anatomical receiving region 60. The induced MR signal is thenreceived by RF receiver 28 via the integrated RF coils. The RF receiver28 conveys the received MR data to a temporary data buffer 30 from wherethe MR data processor 32 reconstructs the MR data into an imagerepresentation of the patient breast.

The planning processor 36 receives the image representation from the MRdata processor 32 and automatically or semi-automatically analyzes theimage representation to detect tissue masses or malignancy S110 in thepatient breast. If a tissue mass of interest is detected, the planningprocessor 36 determines a location S112 of the detected tissue massbased on a known location of the fiducial markers 102, 124 of lateraland medial coil devices 62, 63, 90, 64. According to the location of thedetected tissue mass, the planning processor 36 determines an optimaltrajectory S114 for an interventional instrument 120, such as a biopsyneedle. In one embodiment, the planning processor 36 determines S116 thegrid location, targeting block 140 type, guide hole, and interventionalinstrument 142 to perform a selected intervention, such as a biopsy ofthe tissue mass. In another embodiment, the clinician selects anavailable interventional instrument 142 and the planning processor 36determines the grid location, targeting block 140 type, and guide holeposition accordingly.

The examination table is translated out of the examination region 14,and, without repositioning the patient in the patient support 20, theclinician disposes the determined targeting block 140 in the appropriategrid location according to the planning processor 36. In the case wherethe optimal trajectory is via the patient's axilla, the targeting blockis disposed into one of the grid locations on the upper surface for theaxilla grid plate 130. Once the targeting block 140 is positioned in thedetermined grid location and the interventional device 142 is positionedin the determined guide hole, the clinician performs the interventionalprocedure S118, such as a biopsy of the detected tissue mass. During thebiopsy procedure, the clinician may opt to acquired confirmatory imagerepresentations S120 to ensure the interventional device 142 isfollowing the determined optimal trajectory to the detected tissue mass.Generally the interventional procedure is performed with the patient,situated on the support 20, outside of the examination region 14.However, open c-arm type magnets permit the clinician to perform theintervention while the patient is still in the examination region 14. Toacquire a confirmatory image representation, the examination tabletranslates the patient on the support 20 back into the examinationregion 14 and an image representation is acquired. The patient is thentranslated back out of the examination region and the interventionalprocedure is resumed. The ability to acquire image representations andperform an interventional procedure seamlessly without repositioning thepatient provides an improvement in workflow allowing procedures to becompleted in a shorter time frame. Faster turn over for theinterventional procedure incurs a cost savings because the clinicianspends less time during the procedure and more imaging andinterventional procedures can be completed.

The invention has been described with reference to the preferredembodiments. Modifications and alterations may occur to others uponreading and understanding the preceding detailed description. It isintended that the invention be constructed as including all suchmodifications and alterations insofar as they come within the scope ofthe appended claims or the equivalents thereof.

Having thus described the preferred embodiments, the invention is nowclaimed to be:
 1. A method for immobilizing a patient during combined MRimaging and intervention comprising: positioning a patient with apatient breast or axilla anatomical region received in an anatomicalimaging region of a support structure; immobilizing the patientanatomical region between a lateral coil device and a medial coil deviceby independently translating at least one of the lateral and medial coildevices to adapt the anatomical imaging region to the received patientanatomical region, at least one of the lateral and medial coil deviceshaving curved conformal surfaces that conform with at least one of thebreast and the axilla anatomical regions; and inserting aninterventional device along a trajectory through an aperture in theconformal surface into the patient anatomical region.
 2. The methodaccording to claim 1, wherein immobilizing includes: immobilizing atleast one of the patient breast region and the axilla anatomical regionbetween the lateral coil device and the medial coil device byindependently translating at least one of the coil devices with curvedconformal surfaces laterally to adapt the anatomical receiving region tothe patient breast or axilla anatomical region.
 3. The method accordingto claim 1, wherein immobilizing includes: immobilizing the patientaxilla anatomical region between the lateral coil device and the medialcoil device by independently translating the lateral coil devicelaterally to adapt the anatomical imaging region to the patient axillaanatomical region.
 4. The method according to claim 1, whereinimmobilizing includes: improving patient comfort in one of a prone andsupine position by adjusting a head rest which supports the patient'shead and accommodates various neck lengths, a clavicle support whichsupports the patient's clavicle and chest, and a torso support whichsupports the patient's torso and accommodates to various torso sizes. 5.A method for immobilizing a patient during combined magnetic resonance(MR) imaging and intervention comprising: positioning the patient on asupport structure configured to be disposed in an MR examination space;translating at least one coil device disposed on the support structureand defining an anatomical imaging region to adjust a size of theanatomical imaging region, the at least one coil device including ahousing having conformal surface facing the anatomical imaging region,which conforms with a patient anatomical portion to be received in theanatomical imaging region and at least one radiofrequency (RF) coilelement encased in the housing; inducing MR and/or receiving MR signalsfrom the anatomical imaging region with the at least one radiofrequency(RF) coil element; inserting an interventional device along a trajectorythrough an aperture in the conformal surface into the anatomicalportion; and wherein the at least one coil device includes a lateralcoil device and a medial coil device and an axilla coil and wherein theanatomical portion includes at least one of a patient breast and axillaregion and the housing conformal surface is configured to conform atleast one of the breast and axilla region.
 6. The method according toclaim 5, wherein the at least one coil device includes a medial coildevice and two lateral coil devices to define two anatomical imagingregions, each anatomical imaging region being between the medial coildevice and one of the lateral coil devices, at least one of the lateralcoil devices being integral with the axilla coil and further including:with the axilla coil, inducing and/or receiving MR signals from theaxilla region.
 7. The method according to claim 5, further including:sliding the lateral and medial coil devices along tracks defined in thesupport structure to immobilize the patient anatomical portion in theanatomical imaging region with the conformal surface.
 8. The methodaccording to claim 5, further including: illuminating the anatomicalimaging region with a non-ferromagnetic lighting system.
 9. The methodaccording to claim 5, wherein the housing of the lateral and medial coildevices includes MR imageable fiducials and further including:concurrently imaging the patient anatomical structure in the anatomicalimaging region and the fiducials.
 10. The method according to claim 5,including: adjusting an adjustable head rest of the support structure tosupport the patient's head and accommodate the patient's neck length;adjusting an adjustable clavicle support for supporting the patient'sclavicle and chest; adjusting an adjustable torso support to accommodatea size and contour of the patient's torso; adjusting an adjustablesternum support to accommodate the patient's sternum.
 11. The methodaccording to claim 10, wherein adjusting the torso support includes:inflating or deflating an air bladder.
 12. The method according to claim5, further including: controlling an RF transmitter to generate anexcitation signal in the MR examination space and controlling an RFreceiver to receive induced magnetic resonance signals from the lateraland medial coil devices; reconstructing an image representation of thepatient anatomical portion received in the anatomical examination regionfrom the received magnetic resonance signals; and localizing a detectedtissue mass in the imaged patient anatomical region for biopsy inrelation to at least one fiducial marker disposed in the lateral and/ormedial coil devices.
 13. The method according to claim 5, furtherincluding: inserting a target block into the aperture in the conformalsurface to define the trajectory for the interventional device.
 14. Anintegrated magnetic resonance (MR) imaging and intervention methodcomprising: translating a lateral MR coil device and a medical MR coildevice relative to a support structure configured to be disposed in anMR examination space to adjust a size of a breast imaging regiontherebetween, at least one of the lateral and medial coil elements beingencased in a housing having a curved conformal surface facing the breastimaging region, which conformal surface conforms with a patient's breastreceived in the breast imaging region; exciting magnetic resonance atleast in an axilla region of the patient; receiving MR signals with anaxilla RF coil element from the axilla region of the patient, the axillaRF coil element being encased in an axilla housing portion, the axillahousing portion including a conformal surface configured to conform tothe axilla region and defining a plurality of apertures configured toreceive a target block, the axilla housing portion extending from thelateral coil device away from the medial coil device; disposing a targetblock in one of the apertures; inserting an interventional devicethrough the target block along a trajectory defined by the target blockinto the axilla region.
 15. The method according to claim 14, furtherincluding: illuminating the axilla region with at least one of a LED andfiber optic lighting system.
 16. The method according to claim 14,further including: inflating and/or deflating an air bladder to adjust atorso support to accommodate the patient.
 17. The method according toclaim 14, further including: compressing one of the patient's breastwith a mesh fabric attached to a clavicle support and a torso support topermit medial access to the other breast; exciting magnetic resonance inthe patient's breast; and receiving MR signals from the breast with atleast one of the lateral and medial MR coil devices.